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I s s u e N o. 3 9
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A PIONEER IN THE STEM CELL FRONTIER
Our bone marrow contains stem cells with
a special power: they can turn into any
other type of blood cells. Transplants of
these blood (or “hematopoietic”) stem cells
are used to treat patients with cancers such
as leukemia and other disorders of the blood
and immune system.
“They are sophisticated cells that can go
in the direction we need them to,” says Prof.
Prof. Reisner’s technique for
performing transplants between
a mismatched donor and
recipient first helped “bubble
children,” then leukemia patients
– and now he is adapting it
for organ transplants.
Prof. Yair Reisner
Yair Reisner, head of the Weizmann Institute
of Science’s Department of Immunology.
“If we lose red blood cells, these stem cells
will rapidly replenish the red cells, and if
we need white cells, they will switch to
replenish those.”
Having conducted research on stem cell
transplantation for more than 30 years, Prof.
Reisner is expert at finding ways to trick the
human immune system into accepting transplants that it would otherwise reject.
For a stem cell transplant to succeed, the
donor and patient must typically share six
immunological markers. Patients lacking a
suitable donor among siblings (the most likely source for a full match) then look to other
blood relatives, who may be a partial match;
if none is found, the patient must turn to
donor registries. Unfortunately, many in
need of a transplant are unable to find a
match in time.
In the early 1980s, Prof. Reisner pioneered
a method for transplanting stem cells from
family members who are only a partial match.
His technique requires that just three of the
six immunological markers match – a revolutionary breakthrough meaning that a suitable
donor can nearly always be found among
family members.
He collaborated with a team at Memorial
Sloan Kettering Cancer Center in New York
City to use the technique to treat children
suffering from severe combined immune deficiency (SCID). This rare, inherited condition
causes severe abnormalities of the immune
system, and children with SCID (also known
as “bubble children”) are highly susceptible
to life-threatening infections.
Using bone marrow from a parent who was
a partial match for the patient, the team then
treated it with lectin, a soybean derivative,
before transplantation. The lectin neutralized aggressive T cells (a type of white blood
cell involved in the immune response) that
could attack tissues in the recipient’s body.
Once cleansed of these hostile cells, the
donor’s marrow stem cells could be transplanted without fear of rejection. The donated stem cells proliferated, creating the
immunity the patient lacked. Prof. Reisner’s
procedure is today used at hospitals around
the world, saving untold numbers of lives.
Next, Prof. Reisner expanded his technique to leukemia patients who can’t find
a matched bone marrow donor – not even
on donor registries. To accomplish this, he
pioneered another new method: greatly
increasing the amount of stem cells transplanted, so that their sheer volume overwhelms any residual resistance in the recipient. In order to produce this upsurge of
stem cells, he and Prof. Massimo Martelli
of Italy’s University of Perugia treated the
donor with hormone injections for a week.
This releases large numbers of stem cells from
WEIZMANN
Bone marrow stem cells are
powerful: they can become any
other type of blood cell in the
body. In research spanning more
than 30 years, Prof. Reisner has
harnessed them to save lives.
In 1993, these “mega dose” transplants
were used for the first time to treat leukemia
patients in Italy. Now it is offered worldwide
– again saving many lives.
Today Prof. Reisner continues to expand
his research: he is currently adapting the
“mega dose” approach to organ transplantation. With it, “If I transplant my bone marrow
stem cells into your body, you will adopt my
immune system. Then I can give you my
organs and you will accept them without
any need for drugs that suppress the immune
system,” he explains.
The immunosuppressive drugs he refers to
are known to be very hard on the body, with
side effects that can themselves be fatal – and
they must be taken by transplant recipients
for the rest of their lives. Clearly, the ability
to transplant organs without having to use
such dangerous drugs would change the state
of transplant medicine.
Still passionate about his research, Prof.
Reisner enthuses, “This work is very exciting. It’s almost like science fiction.” He feels
fortunate to have met and kept in touch with
many of those who benefited from the treatments he helped develop; in fact, he was
recently invited to the wedding of one of the
first “bubble children” cured by his technique
– a today-healthy young man who was not
expected to live this long. Science fiction?
Perhaps. Real-life science for the benefit of
humanity? Definitely.
While he describes
the technique as
“almost like science
fiction,” Prof. Reisner
sees the real-life
victory: he is still
in touch with many
former patients
who were saved by
his method.
Prof. Yair Reisner’s
research is supported by
the Leona M. and Harry
B. Helmsley Charitable
Trust; the Steven and
Beverly Rubenstein
Charitable Foundation;
and Roberto and Renata
Ruhman, Brazil. Prof.
Reisner is the incumbent
of the Henry H. Drake
Professorial Chair
of Immunology.
The Weizmann Institute of Science in Rehovot, Israel, is one of the world’s foremost centers of scientific research and graduate study. The American
Committee for the Weizmann Institute of Science is a community of dedicated people who share a common vision in support of the Institute. The
generous assistance the Institute receives from individuals, foundations, and corporations is vital for its future. Committee members show their
devotion to the advancement of the Institute’s goals by becoming partners in the search for answers to the most difficult challenges facing humanity.
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06.2015
the bone marrow, which are then cleansed of
T cells – as with the treatment for SCID –
and readied for transplant.
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